This protocol addresses xanthelasma palpebrarum occurring in patients with an identifiable underlying medical disorder — for example, hypothyroidism. In some such cases, effective management of the underlying condition leads to plaque regression; when it does not, a further clinical step is warranted.
The initial approach in this setting is to refer the patient to primary care for treatment of the underlying medical disorder — such as thyroid hormone replacement therapy in the case of hypothyroidism. The expected clinical goal is regression of xanthelasma plaques. When that goal is not achieved and plaques persist, this protocol defines what comes next.
When xanthelasma is recalcitrant to conservative management of the underlying disorder, procedural intervention becomes the focus of treatment. The full evidence-based regimen — specifying which approaches are indicated and how they are applied — is available in the complete protocol.
DOI: 10.1097/01.PRS.0000025626.70065.2B
In some cases, treatment of the underlying medical disorder can cause regression, as in the case of thyroid hormone replacement therapy for hypothyroidism.
In general, treatment methods for xanthelasma include surgical excision, laser ablation, and topical trichloroacetic acid.
None, or recalcitrant to conservative therapy.
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